Iijima H, Tsumura T
Department of Ophthalmology, Yamanashi Medical College, Japan.
Jpn J Ophthalmol. 1994;38(2):202-7.
A 56-year-old man, complaining of sudden visual loss in his left eye, demonstrated cream-colored retinal edema along a macular branch of the central retinal artery, overall delay of fluorescence in angiography and general depression of the central visual field, which were interpreted as the incomplete form of central retinal artery occlusion (CRAO) mimicking cilioretinal or branch retinal artery occlusion. After receiving paracentesis and fibrinolytic agents, the patient recovered his vision gradually, while the ophthalmoscopic findings progressed to show central retinal vein occlusion (CRVO) changes consisting of dilated and tortuous retinal veins and scattered intraretinal hemorrhages. The condition associated with the retinal edema indicated combined obstruction of the central retinal artery and the central retinal vein (combined CRAO/CRVO). Six months later, both the ocular fundus and the vision returned to normal. The similar cases in Japanese literature in which ophthalmoscopic findings of combined CRAO/CRVO was followed by aggravation of CRVO changes with or without recovery of vision were reviewed.
一名56岁男性,因左眼突然视力丧失前来就诊,眼底检查发现沿视网膜中央动脉黄斑分支有奶油色视网膜水肿,血管造影显示荧光总体延迟,中心视野普遍缺损,这些表现被解释为类似睫状视网膜或视网膜分支动脉阻塞的不完全性视网膜中央动脉阻塞(CRAO)。在接受穿刺和纤溶药物治疗后,患者视力逐渐恢复,而眼底镜检查结果进展为显示视网膜中央静脉阻塞(CRVO)的改变,包括视网膜静脉扩张迂曲和散在的视网膜内出血。与视网膜水肿相关的情况提示视网膜中央动脉和视网膜中央静脉联合阻塞(CRAO/CRVO合并症)。6个月后,眼底和视力均恢复正常。本文回顾了日本文献中类似的病例,这些病例中CRAO/CRVO合并症的眼底镜检查结果之后,CRVO改变加重,视力有无恢复情况不一。